Provider Demographics
NPI:1386920932
Name:VOELLER, JULIE ANN (RPH)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:VOELLER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:ANN
Other - Last Name:SANDERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:21065 SW PACIFIC HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:OR
Mailing Address - Zip Code:97140
Mailing Address - Country:US
Mailing Address - Phone:503-625-1805
Mailing Address - Fax:503-625-9240
Practice Address - Street 1:21065 SW PACIFIC HIGHWAY
Practice Address - Street 2:
Practice Address - City:SHERWOOD
Practice Address - State:OR
Practice Address - Zip Code:97140
Practice Address - Country:US
Practice Address - Phone:503-625-1805
Practice Address - Fax:503-625-9240
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-27
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT361924025183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0214166Medicaid